Can daily aspirin help prevent stroke, heart attack?

For people who do not have heart disease, the United States Preventive Services Task Force does recommend that men between the ages of 45 and 79 and women ages 55 to 79 take an aspirin every day to help prevent heart attack and stroke. Before you start taking a daily aspirin, though, it is a good idea to talk to your doctor to make sure that choice is right for you.

Taking aspirin can lower your risk of a heart attack or stroke because of the way aspirin affects the clotting cells in your blood, called platelets. When your body is injured and bleeds, platelets build up at the site of the injury. They form a plug that stops the bleeding.

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Usually, the clotting ability of platelets is a good response that allows your body to start the healing process after an injury. But if your blood clots within a blood vessel, the clot can stop the flow of blood. If this happens in an artery that supplies blood to your heart or head, the result is often a heart attack or a stroke. Aspirin lowers platelets’ ability to clump together, making it less likely that a clot will block one of your blood vessels and cause a stroke or heart attack.

When you talk to your doctor, ask about the daily aspirin dose that’s right for you. For many people, 81 milligrams -- the amount in a baby aspirin -- works well as a daily dose. But some people may need more or less, depending on their medical histories. If you take other medications, they may alter your aspirin dose. Review your list of current medications with your doctor. As with all medications, it is very important to take aspirin exactly as your doctor tells you to.

There has been some discussion among physicians and researchers about whether the aspirin should be coated or uncoated. When aspirin is coated, it can take longer for the medicine to be absorbed into your body. But it has been determined that when taking a daily aspirin for the purpose of preventing heart attack and stroke, the rate of absorption is not a critical issue, so either form is acceptable.

About five percent of people have problems with aspirin causing an upset stomach. If that’s the case for you, coated aspirin is a better option, as it can decrease stomach irritation. The specific brand of aspirin does not make a difference. Choose whatever kind you prefer.

Although taking aspirin every day is useful for many people, there are some for whom it is not recommended. They include people who have health conditions that raise their risk of bleeding, such as clotting or bleeding disorders or bleeding stomach ulcers. Also, anyone with an allergy to aspirin or who has had a reaction when taking aspirin in the past should not take a daily aspirin.

For people who do have a history of stroke, heart disease or other heart problems, a daily aspirin can be useful. But it is very important that those individuals discuss with their doctors the risks and benefits of daily aspirin for their situation. — Brian Shapiro, M.D.,

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